tbuckley/cabot-search huggingface dataset:
POS1138 SIROLIMUS VERSUS MYCOPHENOLATE MOFETIL FOR THE TREATMENT OF LUPUS NEPHRITIS: RESULTS FROM A REAL-WORLD CSTAR COHORT STUDY
Authors: W. Bai, M. LI
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The effectiveness and safety of sirolimus for the treatment of systemic lupus erythematosus (SLE) and lupus nephritis (LN) have been shown in some studies. However, a comparison of sirolimus with standard of care (SoC) for LN patients has not been reported. <h3>Objectives</h3> To compare the effectiveness and safety of sirolimus versus mycophenolate mofetil (MMF) for LN treatment. <h3>Methods</h3> A real-world cohort study based on the Chinese SLE Treatment and Research (CSTAR) registry was conducted. Excluded patients with LLDAS (lupus low disease activity state) or remission at baseline, LN patients who were prescribed sirolimus or MMF were enrolled. Propensity score matching was used to ensure equivalent disease conditions. SLE and LN disease activity indices, serological parameters, steroid doses, and adverse events were compared between the two groups at 3-month, 6-month, and 12-month visits. <h3>Results</h3> Data from 53 patients in each group were analyzed. The clinical effectiveness of sirolimus, including the proportion of patients with LLDAS/remission, or clinical response (SLEDAI-2K reductiongroups at 3-month, 6-month, and 12-month vSystemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scores, physician's global assessment (PhGA) scores, the remission of LN, the change of 24 hours urine protein level, and the steroid tapering effect, were equivalent to those of MMF (P≥0.05). Greater improvements in complement levels were observed in the sirolimus group than the MMF group at 3, 6, and 12 months. Ten adverse events in the sirolimus group and one in the MMF group were recorded. None was severe or led to drug discontinuation. <h3>Conclusion</h3> Sirolimus was as effective as MMF in the treatment of LN and glucocorticoid tapering. Sirolimus had better effects on serological improvement. Sirolimus was well tolerated in LN patients. <h3>References</h3> [1]Peng L, Wu C, Hong R, et al. Clinical efficacy and safety of sirolimus in systemic lupus erythematosus: a real-world study and meta-analysis. Ther Adv Musculoskelet Dis. 2020 Sep 14;12:1759720X20953336. [2]Franklyn K, Lau CS, Navarra SV, et al; Asia-Pacific Lupus Collaboration. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS). Ann Rheum Dis. 2016 Sep;75(9):1615-21. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1192-HPR ASSESSMENT OF KNOWLEDGE AND ATTITUDE IN MOROCCAN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: R. Honsali, T. Latifa, S. Farih, H. Rkain, R. Razine, S. Elhilali, F. El Joumani, S. Bahloul, S. Ez-Zaoui, F. Kronbi, I. Bensaghir, N. Alami, F. Allali
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic, disabling condition that impairs quality of life. <h3>Objectives</h3> The objective of the study was to evaluate the knowledge and attitude of Moroccan patients with rheumatoid arthritis, and to determine the factors associated with them. Thus, it will be possible to set up a targeted education program for a better adherence to treatments. <h3>Methods</h3> This is a descriptive and analytical monocentric study of patients followed up for RA at Al Ayachi University Hospital, Sale, Morocco; and of patients who are members of the Moroccan Association for the fight against Rheumatoid Arthritis (AMP), from December 2021 to July 2022. The consent of the study population was free and informed. The interview questionnaire was developed by the team of rheumatologists and included sociodemographic data, the patients' knowledge about their disease, the treatments and their side effects, the follow-up and the patients' attitude toward self-medication. A score was indicated between 0 and 10 and represents the rate of correct answers per patient. <h3>Results</h3> We recruited 200 patients. The mean age was 55.1 ± 12.0 years, and the majority were women (91%). More than half of the population (57.5%) was illiterate and only 5.5% of the patients had a university education. ¾ of the population was urban (74.5%), and 93% were not working. 64.5% correctly identified the nature of RA as an autoimmune disease, and 26% correctly recognized that RA has a genetic predisposition. 58.5% of patients do not use corticosteroids over the counter against medical advice, 78% do not discontinue corticosteroids abruptly. Whereas 49.4% of patients undergoing biotherapy do not discontinue methotrexate against medical opinion. Moreover, the majority of patients (85%) had a favorable attitude for not accepting paramedic's opinions. Only about a third of patients (30%) knew that pneumopathy could be a possible complication of Methotrexate. 56% did not know what a biomedical drug is, 82.1% did not know that infection is an adverse effect of a biomedical drug, and 98% had no idea what a biosimilar is. The study revealed that 67% of the patients had a total score of correct answers more than 5.0, and the remaining 33% had a score between 2.0 and 4.5. <h3>Conclusion</h3> The level of knowledge of the disease and attitudes among Moroccan patients with RA was globally satisfying. The maintenance and improvement of this level of knowledge and the acquisition of good practices remain fundamental, in particular by diversifying the sources of information: awareness campaign by direct doctor-patient contact, multimedia supports and patients' associations. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1350 FACTORS ASSOCIATED WITH SEDENTARY BEHAVIOR IN KNEE OSTEOARTHRITIS PATIENTS
Authors: A. Adnine, F. Z. Taik, N. Soba, N. Takhrifa, F. Z. Aharrane, M. Fourtassi, F. E. Abourazzak
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Sedentary behavior is linked to poor physical and mental health outcomes. Despite of the known benefits of physical activity in patients with knee osteoarthritis, many individuals remain physically inactive. <h3>Objectives</h3> We aimed at investigating the socio-demographic and clinical factors associated with sedentary behavior (SB) in patients with knee osteoarthritis. <h3>Methods</h3> A cross-sectional study was performed among patients with knee osteoarthritis Aged between 40 and 75 years old who visited the outpatient clinic between April 2022 and October 2022. Patients with knee osteoarthritis were included then classified on the basis of the Kellgren and Lawrence radiograph scale. Socio-demographic and clinical findings were collected. Participants were assessed for pain and disability using visual analogic scale (VAS) and LEQUESNE scale. SB was assessed using the international physical activity questionnaire (IPAQ-SF). Furthermore the participants underwent screening for anxiety and depressive disorders using Patient health questionnaire (PHQ-9) and General anxiety disorder (GAD-7) respectively. <h3>Results</h3> The final study simple was made up of 178 patients with a mean (±SD) age of 58.48 ± 9.9 years, 88.2% of them were females, and 69.1% had comorbidities. Mean (±SD) of pain VAS score upon walking was 4.78 ± 2.21. According to the Kellgren and Lawrence classification, 64.4% of the patients had OA grade 2 and 25.6% had grade 3. Mean of Lequesne scale was 9.8 ± 3.8. The average daily duration of sedentary behavior was 151.02 ± 105.04 minutes. The results of uni and multivariate analysis of associated factors with SB are showed in Table (1): <h3>Conclusion</h3> In the literature few studies discuss factors associated with sedentary behavior in patients with knee osteoarthritis. Our study shows that level of pain and disability are not associated with SB, on the contrary, educational level, socioeconomic status and depressive disorders are the principal factors associated with SB. Our study highlights the importance of therapeutic education and assessment of mental health to improve the management of patients with knee osteoarthritis. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0667 CHARACTERIZING ULTRASOUND-PROVEN ENTHESITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS: PREVALENCE AND IDENTIFICATION OF DISEASE SUBSET WITH LESS FREQUENT RENAL INVOLVEMENT
Authors: F. Fagni, A. Bettiol, E. Silvestri, R. Fedi, A. Palermo, M. L. Urban, R. Mazzotta, D. Malandrino, F. Bello, I. Mattioli, D. Simon, G. Di Scala, G. Schett, D. Prisco, G. Emmi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Musculoskeletal inflammation is a frequent and debilitating feature of Systemic Lupus Erythematosus (SLE) that can involve all components of the joint, including extra-synovial sites such as the entheses<sup>1</sup>. In previous reports, enthesitis could be clearly demonstrated by musculoskeletal ultrasound (US) in small cohorts of patients with SLE<sup>2,3</sup>. However, SLE-enthesitis remains frequently overlooked and its prevalence in real-life cohorts as well as its clinical significance for disease classification and therapy remain to be determined. <h3>Objectives</h3> To assess the prevalence of US-confirmed enthesitis in a monocentric cohort of patients with SLE and to analyze the clinical associations to enthesitis during the course of disease. <h3>Methods</h3> Ultrasound examinations of SLE patients presenting with tender and/or swollen joints at the Lupus Unit of the Careggi University Hospital in Florence (Italy) were retrospectively analyzed to assess the presence of enthesitis. Patients with US-proven enthesitis were compared with SLE controls who showed no US-evidence of enthesitis. Clinical features and therapies were compared between the two groups at disease onset and throughout follow-up. <h3>Results</h3> We assessed 400 patients fulfilling EULAR/ACR classification criteria for SLE. In 106 of them, an US examination of the joints was performed. Evidence of enthesitis was found in 31/106 (29.2%) patients. Four participants were excluded due to lack of follow-up data. The remaining 71 patients without US-enthesitis were included as control group (<b>Figure 1</b>). At disease onset, all clinical features were comparable between enthesitis cases and controls. Clinical manifestations and therapy from disease onset to the last available follow-up are reported in <b>Table 1</b>. The median follow-up was of 10.0 (IQR 8.3-23.3) years for cases and 12.4 (IQR 7.2-13.3) years for controls. Patients with enthesitis were less likely to develop renal involvement (22.6% vs 46.5%, p&lt;0.05), had more arthritis (100.0% vs 81.7%, p&lt;0.01) and failed B-cell depleting therapies more frequently (75.0% vs 0%). <h3>Conclusion</h3> In SLE patients with tender or swollen joints, enthesitis is a fairly common finding. Enthesitis in SLE could be the hallmark of a distinct disease subset with less frequent renal involvement, more arthritis, and poor response to B-cell depletion, potentially requiring alternative treatments. <h3>References</h3> [1]Dörner T, <i>et al. Rheumatol Ther</i> 9, 781–802 (2022) [2]Di Matteo A, et al. <i>Rheumatology</i> 57:1822–9 (2018) [3]Di Matteo A, et al. <i>Lupus</i> 26:320–8 (2017) <h3>Disclosure of Interests</h3> None declared
AB0251 RELATIONSHIP BETWEEN ANXIETY, DEPRESSION AND FUNCTIONAL DISABILITY IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: M. Brahem, R. Sarraj, O. Jomaa, S. Abdellatif, B. Jebali, H. Hachfi, Y. Mohamed
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The management of rheumatoid arthritis (RA) must be multidisciplinary in order to relieve pain, prevent functional disability and improve quality of life. <h3>Objectives</h3> The objective of this study was to evaluate the impact of functional status on the psychological state in patients with RA. <h3>Methods</h3> This is a cross sectional study conducted among patients diagnosed with RA based on ACR/EULAR criteria. We assessed them for anxiety and depression symptoms using the Hospital Anxiety and Depression scale (HADS). The functional status was assessed by the Health Assessment Questionnaire (HAQ). <h3>Results</h3> A total of 100 RA patients were included in this study. There were 89 females (89% of cases) and 11 males (11%). The mean age of participants was 53.2 years [21-76 years]. The average duration of disease was 11.1 years [1-40 years]. Very active RA disease (DAS 28 greater than 5.1) was observed in 34 patients. The mean HAQ value was 1.28 [0-2.87]. 25% of our patients had high functional disability (HAQ &gt;2). Nearly half of the study population (54% of cases) suffered from depression and/or anxiety symptoms. The mean HADS-D score was 8.39 [0-16] and thirty patients (30% of cases) had certain depressive symptoms (HADS-D ≥11). The mean HADS-A score was 7.79 [0-15] and 24 of our patients (24% of cases) presented certain symptoms of anxiety (HADS-A≥11). In statistical analysis, the HAD-A scale was associated with higher HAQ level (p&lt;0,01). In addition, depressive patients (HADS-D ≥11) had higher HAQ level than patients without signs of depression with significant difference (p&lt;0.01). <h3>Conclusion</h3> Our study showed that more than quart of RA patients suffers from anxiety and/or depression, and these troubles were related to functional disability. This suggests that treatment should focus also on improving physical function, detection and management of depression or anxiety. <h3>References</h3> [1] Uda M et al. Factors associated with anxiety and depression in rheumatoid arthritis patients: a cross-sectional study. Adv Rheumatol. (2021 Dec) [2] Fragoulis GE et al. Depression and anxiety in an early rheumatoid arthritis inception cohort. associations with demographic, socioeconomic and disease features. RMD Open. (2020 Oct) <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1828-HPR ASSOCIATION BETWEEN COMPLEMENTARY AND ALTERNATIVE MEDICINE USE AND TRUST IN THE PHYSICIAN IN PATIENTS WITH INFLAMMATORY RHEUMATISM?
Authors: F. Z. Aharrane, F. Z. Taik, N. Takhrifa, R. Bensaid, M. Fourtassi, F. E. Abourazzak
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Generally, patients with chronic rheumatic diseases use complementary and alternative medicine (CAM) in addition to their conventional treatments to manage their health. Discussing these treatments with their physician is still rare, which might be directly related to patients' trust toward them. <h3>Objectives</h3> The primary objective of this study was to assess the association between patients' trust in their physician and the use of complementary and alternative medicine. As a secondary objective, to estimate the prevalence of complementary and alternative therapy use among patients with chronic inflammatory rheumatism. <h3>Methods</h3> This is a cross-sectional study, which included patients with established chronic inflammatory rheumatism, followed at the University Hospital Center in Tangier. The questionnaire included demographic and clinical information, use of conventional therapy, complementary and alternative therapy, as well as the interpersonal trust in patient-physician relationships using the Trust in Physician Scale (TPS). <h3>Results</h3> The study included 189 patients. 57.14% of patients reported using complementary medicine at least once, most patients were women (77.78%), mean age was 46.67±13.25 years with an average course of the disease 11.11±9.23 years. The most frequent used complementary and alternative treatments were cupping therapy (45.90%), massage (40.40%) and the ingestion of a mixture of plants (27%). Mean±SD Trust in Physician Scale was 47.64 ±7.2, and there were no significant differences between CAM users vs. non-users (48.08±6.9 vs. 47.04±7,4; p=0,35). <h3>Conclusion</h3> More than half of patients with inflammatory rheumatism reported the use of complementary and alternative medicine. However, the association between their use and trust in the physician assessed with TPS was not established. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1080 IS HLA-B27 ASSOCIATED WITH BIOMARKERS OF OSTEOFORMATION IN SPONDYLOARTHRITIS? RESULTS OF A STUDY FROM NORTH AFRICA
Authors: K. Maatallah, Z. Zeineb, I. Ayadi, H. Ferjani, M. Kallel Sellami, D. Ben Nessib, D. Elhaj Mahmoud, W. Kaabachi, D. Kaffel, L. Laadhar, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The Wnt signaling pathway is a signaling pathway regulating bone metabolism. Dickkopf1 (DKK-1) and Sclerostin are potent inhibitors of this pathway, and their dysfunction would be responsible for osteoformation phenomena in patients with spondyloarthritis (SpA). Osteoprotegerin (OPG), a potent inhibitor of osteoclasts and regulated by the Wnt pathway, has also been implicated in this osteoformation phenomenon. <h3>Objectives</h3> Our work aimed to determine the associations between serum levels of DKK-1, Sclerostin, OPG, and the HLA B-27 allele. <h3>Methods</h3> It was a cross-sectional study including patients with SpA (meeting ASAS criteria). Data collected included sociodemographic and disease characteristics. Biomarker assays were performed using an ELISA technique. Human leukocyte antigen typing was performed by a specific polymerase chain reaction. <h3>Results</h3> One hundred and nine patients were included, with a mean age of 43 ± 12 [19-79] years and a sex ratio M/F of 1.65. The mean age of onset of the disease was 30.6 ± 11 years. Seven patients had a juvenile onset of the disease. HLA B27 allele was present in 30 patients (27.52%). The respective medians [range] of serum levels, in pg/mL, of DKK-1, Sclerostin, and OPG were 146.7 [0-455,3], 32.8[0-488], and 471 [0-1613,6]. HLA B27 was not associated with any of these biomarkers (DKK-1; p=0.744), (Sclerostin; p=0.870), (OPG; p=0.835). <h3>Conclusion</h3> Our study suggests that there is no association between inhibitors of the Wnt signaling pathway as well as OPG and HLA B27. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0666 THE RELATIONSHIP BETWEEN NEUROPATHIC PAIN AND AUTOANTIBODY POSITIVITY AND SALIVARY GLAND BIOPSY IN PATIENTS WITH PRIMARY SJÖGREN’S SYNDROME
Authors: C. Arslantürk Güneysu, D. Karatas, N. Erdik, S. M. Türk, G. Yavuzbilge, S. B. Acikgoz, Z. Öztürk, A. Karakurt, E. Gönüllü
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Sjögren's syndrome (SjS) is an autoimmune disease characterized by exocrine gland inflammation (1). Extraglandular manifestations are common in SjS. Some articles reported neuropathic pain in 40% of patients with SjS (2). Autoantibodies (SS-A, SS-B, Anti Ro-52) and salivary gland biopsy are used to diagnose SjS. The relationship between autoantibody, salivary gland biopsy results, and neurological involvement is unclear. <h3>Objectives</h3> In this study, autoantibody positivity and salivary gland biopsy results were compared with the frequency of neuropathic pain. <h3>Methods</h3> Patients with a diagnosis of Primary SjS who visited the rheumatology outpatient clinic of Sakarya University between August 2021 and August 2022 were included in the study. The results of salivary gland biopsy and autoantibody (ANA, SS-A, SS-B, Anti-Ro 52) were analyzed. The LANSS (The Leeds Assessment of Neuropathic Symptoms and Signs) pain scale was used to define neuropathic pain. Obtained data were evaluated with Chi-Square and Mann-Whitney U test. <h3>Results</h3> Sixty-six patients were included in the study. Patients' age (mean): 53.5±11.3 years; genders were 3 (4.5%) male and 63 (95.5%) female. While 18 (27.3%) patients have neuropathic pain, 48 (72.7%) patients did not have neuropathic pain. No statistically significant difference was found between neuropathic pain and disease duration (p=0.584). There was no difference in neuropathic pain in terms of gender (p=0.178). While the rate of neuropathic pain was 25.6% in patients with a focus on biopsy, it was 45.5% in patients without focus, and the difference was not statistically significant (p=0.270). No statistically significant correlation was found between anti-SSA, Anti-SSB, and Anti-Ro52 positivity and neuropathic pain. In ANA-negative patients, the increase in the frequency of neuropathic pain was statistically significant (p=0.031). <h3>Conclusion</h3> In this study, we did not find a relationship between antibody positivity, focus score, and the frequency of neuropathic pain. <h3>References</h3> [1]Segal BM, Pogatchnik B, Henn L, Rudser K, Sivils KM. Pain severity and neuropathic pain symptoms in primary Sjögren's syndrome: a comparison study of seropositive and seronegative Sjögren's syndrome patients. <i>Arthritis Care Res (Hoboken</i>). 2013;65(8):1291-1298. doi:10.1002/acr.21956 [2]Omdal R, Mellgren SI, Norheim KB. Pain and fatigue in primary Sjögren's syndrome [published online ahead of print, 2019 Feb 27]. <i>Rheumatology (Oxford</i>). 2019;kez027. doi:10.1093/rheumatology/kez027 <h3>Disclosure of Interests</h3> None declared
POS1577 VENOUS INFLAMMATION MIGHT BE ONE OF THE FEATURES OF VEXAS SYNDROME AND ASSOCIATED THROMBOSIS
Authors: H. Karadeniz, M. Cerit, A. Tufan, Y. Kanthi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> VEXAS syndrome is an often fatal, X-linked disease characterized by hematological dysplasia overlapping with severe autoinflammatory manifestations. Thrombosis, predominantly as unprovoked venous thrombosis, has been reported in up to 56% of VEXAS patients. Although chronic inflammation, vasculitis, endothelial dysfunction, disrupted anticoagulant mechanisms, or prothrombotic antibodies are suggested mechanisms, the exact pathogenesis of thrombosis is yet to be elucidated. VEXAS has clinical similarities with Behçet's syndrome (BS), a systemic vasculitis involving arterial and venous vessels of all sizes. Recently, venous wall thickening (VWT) on Doppler ultrasound has been shown to be a highly sensitive and specific (&gt;80%) finding for the diagnosis of BS. Given the clinical and pathogenetic similarities with BS, we thought venulitis might be the underlying cause of thrombosis in VEXAS syndrome. <h3>Objectives</h3> Herein, we report venulitis in two consecutive VEXAS patients with the demonstration of severe thickening of the walls of large veins. <h3>Methods</h3> Bilateral lower extremity common femoral veins (CFV) were examined with Doppler ultrasound in craniocaudal direction for the presence of thrombi, occlusion, venous insufficiency, and arterial occlusive disease. VWT was measured using the methodology described by Alibaz-Oner F et al. <b>[1].</b> All measurements were performed thrice, and the arithmetic mean of them was given as the result. We also assessed the internal jugular vein (IJV) in one patient but not in the other due to the jugular venous catheter. VEXAS patients had thickened walls on ultrasound in all examined large veins. <h3>Results</h3> Demographic and clinical features of our VEXAS patients are presented in Table 1. VWT in BS seemed significantly greater than non-inflammatory DVT (0.34±0.1 mm) but not significant with the anti-phospholipid syndrome (APS, 0.49 ±0.1 mm) <b>[2].</b> Our VEXAS patients had VWT greater than BS and APS suggesting remarkable vein inflammation. Patients with extensive thrombosis (Case#1) had the most severe VWT of CFV on the affected side, while the latter case (Case#2) had equivalent VWT in both CFVs. <h3>Conclusion</h3> Consequently, our findings suggest that venulitis might be one of the features of VEXAS syndrome and the underlying mechanism for thrombosis. Further studies are needed to clarify the role of inflammation in venous thrombotic diseases. <h3>Reference</h3> [1]Alibaz-Oner F, Ergelen R, Yildiz Y, et al. Femoral vein wall thickness measurement: A new diagnostic tool for Behçet's disease. Rheumatology (Oxford). 2021 Jan 5;60(1):288-296. doi: 10.1093/rheumatology/keaa264. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.